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Clinical Trial
. 2013 Jul;48(7):947-52.
doi: 10.1038/bmt.2012.276. Epub 2013 Jan 21.

A pilot study of tandem high-dose chemotherapy with stem cell rescue as consolidation for high-risk neuroblastoma: Children's Oncology Group study ANBL00P1

A E Seif  1 , A Naranjo, D L Baker, N J Bunin, M Kletzel, C S Kretschmar, J M Maris, P W McGrady, D von Allmen, S L Cohn, W B London, J R Park, L R Diller, S A Grupp
Affiliations
Clinical Trial

A pilot study of tandem high-dose chemotherapy with stem cell rescue as consolidation for high-risk neuroblastoma: Children's Oncology Group study ANBL00P1

A E Seif et al. Bone Marrow Transplant. 2013 Jul.

Abstract

Increasing treatment intensity has improved outcomes for children with neuroblastoma. We performed a pilot study in the Children's Oncology Group to assess the feasibility and toxicity of a tandem myeloablative regimen without TBI supported by autologous CD34-selected peripheral blood stem cells. Forty-one patients with high-risk neuroblastoma were enrolled; eight patients did not receive any myeloablative consolidation procedure and seven received only one. Two patients out of 41 (4.9%) experienced transplant-related mortality. CD34 selection was discontinued after subjects were enrolled due to serious viral illness. From the time of study enrollment, the overall 3-year EFS and OS were 44.8 ± 9.6% and 59.2 ± 9.2% (N=41). These results demonstrate that tandem transplantation in the cooperative group setting is feasible and support a randomized comparison of single vs tandem myeloablative consolidation with PBSC support for high-risk neuroblastoma.

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Conflict of interest statement

Conflicts of Interest

None.

Figures

Figure 1
Figure 1. Schema of induction, consolidation and post-consolidation therapy
Cycle 1 included cisplatin 40 mg/m2 over 5 days plus etoposide 200 mg/m2 on days 2–4. Cycles 2 and 5 included vincristine 1.5 mg/m2 plus doxorubicin 60 mg/m2 on day 1 and cyclophosphamide 2,000 mg/m2 on days 1 and 2. Cycle 3 included ifosfamide 1.8 g/m2 plus etoposide 100 mg/m2 over 5 days. Cycle 4 included carboplatin 500 mg/m2 over 2 days plus etoposide 150 mg/m2 over 3 days. Abbreviations: CI, continuous infusion over 24 hours; PBSC, peripheral blood stem cell; XRT, radiotherapy; 13-cis-RA, 13-cis-retinoic acid.
Figure 2
Figure 2. Event-free survival (EFS) and overall survival (OS) for 41 patients with high-risk neuroblastoma on COG study ANBL00P1
The number at risk for an event at the start of years 2 and 4 are given along the curves.
See this image and copyright information in PMC

References

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